| Syncope as a predictor of sudden cardiac arrest: a nationwide population-based study |
Yun Gi Kim1, Yeji Kim2, Joo Hee Jeong1, Kyung-Do Han3
, Chang-Ok Seo1, Hyoung Seok Lee4, Jaemin Shim1, Young-Hoon Kim1, and Jong-Il Choi1
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1Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine and Korea University Anam Hospital, Seoul, Korea
2Division of Cardiology, Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea
3Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
4Division of Cardiology, Department of Internal Medicine, Inha University Hospital, Inha University College of Medicine, Incheon, Korea |
Corresponding Author:
Kyung-Do Han , Tel: +82-2-820-7025, Fax: +82-2-823-1746, Email: hkd917@naver.com
Jong-Il Choi , Tel: +82-2-920-5445, Fax: +82-2-927-1478, Email: jongilchoi@korea.ac.kr
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Received: July 1, 2025; Revised: April 21, 2026; Accepted: May 13, 2026. |
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| Abstract |
Background/Aims: The risk of sudden cardiac arrest (SCA) in patients with prior syncope events is not fully understood. We examined the association between syncope and the risk of future SCA.
Methods: Data were obtained from the Korean National Health Insurance Service database. Of those individuals who underwent the 2012 health screening, 40% were randomly sampled. The diagnoses of syncope and SCA were based on the International Classification of Disease, 10th edition.
Results: A total of 4,600,635 subjects were analyzed with a mean of 9.2 ± 1.3 years of follow-up. The incidence of SCA per 1,000 person-years were 0.96 and 0.50 in people with and without syncope, respectively, within 5 years prior to health screening (hazard ratio [HR], 1.91; p < 0.001). After adjusting for various confounders, the presence of syncope was associated with a 29% increased risk of developing SCA (HR, 1.29; p < 0.001). Syncope within 3 years and within 1 year prior to health screening was associated with a 30% and 36% increased risk of SCA, respectively. Dizziness was not associated with the risk of future SCA. Significant interactions of syncope with age/hypertension were observed in young and hypertension-free individuals, who were more vulnerable to SCA.
Conclusions: Syncope may be a surrogate marker of future SCA. The association was attenuated after adjusting for various confounders. The risk increased by 91% and 29% before and after adjustment, respectively. Individuals with prior syncope, older age, male sex, and cardiometabolic disorders had a higher risk of future SCA. |
| Keywords:
Sudden cardiac arrest ; Death, sudden, cardiac ; Syncope |
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